Anticoagulation for venous thromboembolism. What are the current options?
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Venous thromboembolism remains an important cause of considerable morbidity and mortality. Low-molecular-weight heparin appears to be a safe and effective alternative to unfractionated heparin for inpatient treatment. In addition, we recommend considering its use in outpatient treatment in selected patients. When warfarin therapy is initiated, the starting dose should approximate the suspected maintenance dose. The optimal length of anticoagulation after an initial episode of venous thromboembolism is 6 months unless a persistent risk factor is identified. Thrombolytic therapy for hemodynamically stable patients remains controversial, primarily because of the potential for devastating complications.
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